A psicoterapia breve infantil (PBI), aqui entendida como uma modalidade de intervenção terapêutica com duração limitada e objetivos circunscritos, dirigida a crianças e pais, é um importante recurso para que se possa oferecer assistência psicológica a uma parcela mais ampla da população. Apesar disso, e de seu potencial preventivo, tem sido alvo de um número restrito de estudos. Este trabalho tem o objetivo de contribuir para seu desenvolvimento, oferecendo um panorama dos conhecimentos da área e propondo diretrizes que auxiliem na organização do raciocínio clínico para o planejamento terapêutico. Inicia-se por um levantamento e uma análise crítica da evolução histórica desta modalidade de intervenção, desde 1942 até os dias de hoje, e propõe o delineamento de modelos de trabalho em PBI, com o intuito de organizar as contribuições de diferentes autores. A seguir, apresenta um estudo da evolução dos critérios de indicação utilizados por esses autores. Constata que esses critérios, ao longo do tempo, foram se tornando mais flexíveis, e que foi se instalando uma tendência a que a psicoterapia seja planejada de acordo com as necessidades e possibilidades de cada paciente. No caso de crianças, propomos que essa adaptação da proposta de trabalho às características individuais leve em conta, como elemento central, o referencial do desenvolvimento. Nesta direção, este trabalho utiliza-se da teoria do desenvolvimento de Erik Erikson para, em conjunto com os conhecimentos teóricos que constituem a base da PBI psicodinâmica, elaborar parâmetros que auxiliem na organização do raciocínio clínico para a compreensão diagnóstica dos casos e para o planejamento do processo psicoterápico. Para ilustrar esta proposta de análise, são apresentados seis casos clínicos de crianças, duas com idades entre três anos e cinco anos e onze meses, duas entre seis anos e oito anos e onze meses, e duas entre nove anos e dez anos e onze meses. Todas foram submetidas a um psicodiagnóstico breve em condições naturais de atendimento em clínica-escola. Conclui-se que a teoria do desenvolvimento de Erikson se mostrou compatível com o referencial teórico da PBI psicodinâmica, em especial devido a seu caráter epigenético, relacional e contextualizado. Além disso, a integração desses referenciais se mostrou possível e efetiva, facilitando a identificação de conflitos centrais e de padrões de relacionamento transgeracionais, a partir dos quais esses conflitos se constituem e se manifestam. Ainda, possibilitou a organização de parâmetros para o planejamento terapêutico, em especial no que diz respeito à construção do foco e das estratégias de intervenção, e ao papel do terapeuta. / Brief psychotherapy for children (BPC), here understood as a modality of therapeutic intervention with limited duration and circumscribed objectives, directed at children and parents, is an important resource in the offering of psychological assistance to a greater part of the population. Despite this, and its preventive potential, it has been the object of a restricted number of studies. This work aims at contributing to its development, offering an overview of the knowledge in the area and proposing guidelines for the organization of clinical reasoning for therapeutical planning. It begins with a survey and critical analysis of the historical evolution of this modality of intervention, from 1942 to the present day, and proposes the delineation of models of BPC, with the intention of organizing the contributions of different authors. After that, it presents a study of the evolution of the indication criteria adopted by these authors. It reveals that these criteria have become more flexible throughout time, and that a trend has been established for psychotherapy to be planned in accordance with the needs and possibilities of each patient. In the case of children, we consider that this adaptation of the work proposal to individual characteristics should take into account, as a central element, the referential of development. In this direction, this work uses Erik Erikson’s development theory in order to, together with the theoretical knowledge that constitutes the basis of psychodynamic BPC, set parameters to assist in the organization of clinical reasoning for diagnostic understanding of the cases and for the planning of the psychotherapeutic process. To illustrate this analysis proposal, six clinical cases of children are presented, two between the age of 3.0 and 5.11 years old, two between 6.0 and 8.11 years old, and two between 9.0 and 10.11 years old. All had been submitted to a brief psychodiagnosis in natural conditions of attendance in a training clinic. One concludes that Erikson’s development theory is compatible with the theoretical referential of psychodynamic BPC, specially because of its epigenetic, relational and contextualized characteristics. Moreover, it was observed that the integration of these referentials was possible and effective, that it facilitated the identification of central conflicts and transgenerational relationship standards, from which these conflicts constitute and reveal themselves. It also made possible the organization of parameters for therapeutic planning, specially for the construction of focus and intervention strategies, and for the role of the therapist.

Parenting self-efficacy is one factor identified as relevant to parent distress and child therapy outcomes. Theories for parenting self-efficacy suggest parents of children with autism spectrum disorders (ASD) may be at risk for lower parenting self-efficacy than other parents. Parents who have low parenting self-efficacy may then have higher risk for poor treatment outcomes. Previous researchers found inconsistent results related to parenting self-efficacy rates for parents of children with ASD. They suggested the results were due to sample sizes, measurement insensitivitiy, comparison groups, and the limited range of children's ages (Fields, 2006; Meirsschaut, Roeyers, and Warreyn, 2010; Palafox, 2004; and Rutgers et al., 2007). In the current study, the researchers invited 598 parents to complete a series of questionnaires. Participants included the parents of children with ASD (n = 57), Down syndrome (n = 24), ASD and Down syndrome (n = 41), emotional and behavioral disorders (n = 287), and no identified diagnoses (n = 189). The parents who participated were 90.2% female and 84.9% Caucasian. Participants from the ASD, ASD with Down syndrome, and Down syndrome groups lived in higher income households (75.2% above $30,000 annually) than those in the emotional and behavioral disorder group (94.1% below $30,000 annually). The questionnaires asked parents to rate themselves regarding parenting self-efficacy, parent distress, parenting skills, social support, and answered demographic questions. Parents from the diagnostic groups also rated their child's behavior and symptom severity. Parents from the ASD, Down syndrome, and ASD with Down syndrome groups answered additional questions found to be relevant in Fields, 2007 (e.g. age of symptom onset, number of siblings, and parent's age). Parents of children with ASD were found to have the lowest rates of parenting self-efficacy across the five groups. ANOVA rejected the null hypothesis that the groups would be the same (F = 8.24, df = 4, 595, p < .01, adjusted R² = .05). The effect size for the relationship between diagnosis and parenting self-efficacy was small to moderate, accounting for 5% of the variance of parenting self-efficacy scores. Pairwise comparisons between groups found parents of children with ASD to have significantly lower parenting self-efficacy than the Down syndrome (mean difference = -3.32, se = .81, 95% CI = -5.86, -.78), and community groups (mean difference = -2.89, se = .58, 95% CI = -4.47 to -1.31). Parents from the community group were also found to have higher parenting self-efficacy than the parents of children with emotional and behavioral disorders (mean difference = 1.43, se = .37, 95% CI = 1.31, 4.47). Parenting self-efficacy was also related to parent distress, social support, parenting skills, and child's age. Parenting self-efficacy may warrant monitoring in the treatment of ASD and may be an important point of intervention in therapy.

Thesis (M.S.W.)--Smith College School for Social Work, Northampton, Mass., 2008. / Typescript. Includes bibliographical references (leaves 63-68).

Thesis (M.A.) - Carleton University, 2002. / Includes bibliographical references (p. 88-95). Also available in electronic format on the Internet.

Thesis (Ph. D.)--Ohio State University, 2007. / Title from first page of PDF file. Includes bibliographical references (p. 100-106).

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Several issues pass through the mind of the therapist who ventures into the field of child psychotherapy, making them reflect and seek knowledge to guide their practice. This study aimed to investigate how children under psychological care in public health institution, in basic health institution, represent their therapy and their therapist. For this purpose, a qualitative study was carried out, using the draw and tell a story procedures. Eight children between five and twelve years old participated in this study. The children were asked to perform a sequence of three drawing-stories. The data analysis was performed using content analysis. The results are presented in the form of scientific papers. The first article focuses on the representation of the psychotherapy and the second on the representation of a psychotherapist. The results of the first study showed that children experienced their therapy as a place where they could play and talk about themselves. The emphasis given by the children to the ludic resources and to the conversations points out the importance of these therapeutic tools, since they enable children to communicate and work on their issues. Moreover, the treatment was experienced by the children as a place where changes happen in order to achieve therapeutic gains and improvements. The results of the second study suggest that children have a representation of a psychologist as someone who plays and talks with them. In order to make the therapeutic process happen, the ability of the professional to provide a reliable and supported environment was valued. In this place, the child feels safe to bring up their issues, highlighting the holding received during the treatment. The final considerations highlight the possibility of having services of quality in public health institutions, since psychotherapy has been experienced by children as the literature indicates, that is, regardless the place it happens and the people who take it. / Várias questões invadem a mente do terapeuta que se aventura no campo da psicoterapia com crianças, fazendo com que este reflita e busque conhecimentos que norteiem a sua prática. Neste sentido, o presente estudo teve como objetivo investigar a forma como crianças que estavam em atendimento psicológico em instituição pública de saúde, em atenção básica, representam a sua terapia e o seu terapeuta. Com este intuito, realizou-se um estudo qualitativo com a aplicação da técnica do desenho-estória. Participaram deste oito crianças com idade entre cinco e doze anos incompletos. Foi solicitado às crianças que realizassem uma sequência de três desenhos-estórias. A análise dos dados coletados foi feita através de análise de conteúdo. Os resultados são apresentados no formato de artigos cientificos. O primeiro artigo versa sobre a representação de psicoterapia e o segundo sobre a representação de psicoterapeuta. Os resultados do primeiro artigo evidenciam que as crianças vivenciaram a sua terapia enquanto um espaço onde elas puderam tanto brincar quanto falar sobre si. O destaque dado pelos infantes aos recursos lúdicos e ao conversar salienta a valorização destes enquanto dispositivos que as possibilitaram comunicar e trabalhar as suas questões. Além disto, o tratamento foi experienciado pelas crianças como um lugar destinado a estas realizarem mudanças com o intuito de alcançarem ganhos terapêuticos e melhorarem. Por sua vez, os resultados do segundo artigo apontam que as crianças têm uma representação de psicólogo enquanto alguém que brinca e conversa com elas. Para que o processo terapêutico se dê, foi valorizada a capacidade do profissional prover um ambiente confiável e amparador, no qual a criança se sinta segura para trazer as suas questões, sendo destacado nesse sentido o holding recebido ao longo do tratamento. As considerações finais destacam a possibilidade da implantação de serviços de qualidade em instituições públicas de saúde, uma vez que a psicoterapia foi vivenciada pelas crianças como a literatura aponta que ela deve ser independente do lugar em que ela se dá e das pessoas que ela atende.

O interesse por este trabalho surgiu de nossa experiência com casos de adoção no Grupo Acesso Estudos, Pesquisa e Intervenção em Adoção, no Instituto Sedes Sapientiae. Lá acompanhamos casos com abruptas retiradas de crianças dos abrigos, para inserção nas famílias adotivas, sem prévia preparação. Esta exposição de crianças a delicadas experiências de abandono psíquico demonstrou a necessidade de estudarmos este tema. Pretendemos abordar a adoção de crianças entre dois a cinco anos, buscando focalizar o momento específico de seu desligamento do abrigo e a entrada na família adotiva. Procuraremos investigar quais as angústias presentes neste momento de rupturas de vínculos significativos e que impõe a necessidade de construção de novos investimentos afetivos. Utilizaremos, para esta pesquisa, o método psicanalítico, através do qual analisaremos relatos transcritos do atendimento psicoterápico de uma criança que nos procurou, buscando ser ajudada na colocação em família adotiva. Os atendimentos tiveram início quando a criança ainda encontrava-se no abrigo e estenderam-se até a chegada na família adotiva. O trabalho baseou-se em referenciais psicanalíticos, sendo também esta a referência teórica para a compreensão da paciente. Procuraremos demonstrar como uma criança adotada pode experimentar significativas descontinuidades, decorrentes de rupturas de seus vínculos anteriores, e que a elaboração psíquica destas perdas deve ser levada em conta no processo de adoção, podendo interferir no estabelecimento das novas relações familiares. Além disso pretendemos investigar a função do setting terapêutico como um espaço possibilitador de transicionalidade, na passagem para a família adotiva. / Our interest on this topic resulted from our experience with adoption cases seen at Grupo Acesso Adoption Studies, Research and Intervention, at the Sedes Sapientiae Institute. This group gives support to children who have been abruptly withdrawn from social care to be inserted into an adoptive family, without being prepared for this change. We believe the exposure of such children to a delicate situation of psychological neglect should be further analyzed. This study analyses the adoption of children with ages ranging from two to five years, focusing particularly on the moment when the child leaves social care to become a member of the adoptive family. We will investigate the type of distress that occurs at this moment where significant bonds will be disrupted and the construction of new emotional investment will be required. Psychoanalytical methodology will be used to analyze the psychotherapeutical follow-up reports of a child who was brought for support during the adoption process. Our work was based on psychoanalytical references which were also used as theoretical background to understand the patient. We intend to demonstrate that an adopted child may experience significant disruption as a result of the discontinuation of previous affectional bonds, and that psychological preparation for this loss should be provided during the adoption process, as it may interfere with the development of new family ties. Furthermore, we investigate the role played by therapeutic support as a setting that enables transicional phenomena on the way to becoming a member of an adoptive family

M.A. / Children are so often seen as unproductive, dependents that are vulnerable and not responsible for their own actions. Children are in fact individuals in the process of development that can learn to act in a responsible way and to manage their lives. Because children are in the process of development and change, it is a challenge for the therapist to meet the unique needs of the child. This study was developed as a response to a need under social workers for structure in the handling of children with adaptation problems. Social workers need more than just techniques that can be utilized with children in therapy. They also need guidelines on the best techniques to utilize in different phases of the process. This programme aimed at developing an integrated model for child therapy that can be utilized for children who have experienced trauma, who have difficulties adapting to new circumstances, who have behavioural problems or who are in need of personal skills. The Intervention Design and Development Model of Rothman and Thomas (1994) was utilized in the development of the new technological item. The different phases used in the development of the model for child therapy were the following: The problem analysis and planning phase, which included the planning of the study and the setting of goals for the study. The information gathering and synthesis phase, which included an investigation into the available sources for the development of new technology for child therapy. The first focus of the actions in this phase was to identify applicable sources that could be utilized to formulate a theoretical basis for the new technology. The theoretical basis served as a frame of reference to identify the most important aspects of a child that a therapy model should take into account. The next focus was to select existing interventions and technologies that could be used to formulate a practice model that would address the needed aspects of a child. The design phase, consisted of setting a preliminary product. The evaluation phase, which included the implementation of the pilot test and both the process and outcome evaluation. The aim of this phase was to test the programme and to see what can be done to improve on the results and to refine the final product. The implementation and dissemination phase which concluded the study by setting the final product ready for distribution. This product, a model for Functional child therapy, does not provide a recipe for child therapy, nor does it only help children to work through present traumas. The main focus of the model is to help children to become unique individuals within a world that is dominated and structured by adults. Children learn with this model not just to react on adult behaviour, but to become active, responsible role players in their own world.

This thesis aims to increase the knowledge of courses and processes of change prior to and during psychodynamic child psychotherapy with parallel parent contact. The dissertation examines parents’ and psychotherapists’ stated goals and expectations prior to the child’s psychotherapy, processes of change focusing on the psychotherapeutic encounter between child and psychotherapist, and outcome gauged by standardized measures compared to experienced change regarding the child’s problems. This dissertation also wants to examine different instruments for describing the psychotherapeutic process. Data was collected from systematic case studies, at different times during the course of psychotherapy, with material from different sources, such as child psychiatric assessment before and after conducted psychotherapy, questionnaires, and video taping of therapy sessions. By examining the therapeutic encounter from the perspectives of child, parent and psychotherapist, an image of psychotherapy, which illustrates the complexity of the psychotherapeutic process, was created. The thesis is based on three articles: Study I examines parents’ and psychotherapists’ goals and expectations prior to psychotherapy. Study II is a close study of a video-taped individual therapy, in which the interaction between child and therapist is examined with the rating instrument Child Psychotherapy Q-set (CPQ), the psychotherapist’s description of the psychotherapy’s process, and the self-rating instrument Feeling Word Checklist (FWC-24). Study III examines change in global functioning ability after child psychotherapy. By examining several psychotherapies in order to construct qualitative understanding of low and high change, respectively, in rated global functioning, limitations in the rating instrument Children’s Global Assessment Scale (CGAS) are analyzed. The results point to: 1. The need for a culture of cooperation between family and the one conducting the treatment, where goals are formulated together and in accordance with the family’s frame of reference and life experiences, which can increase the possibility of creating positive expectations, and of adapting treatment to the family in question. 2. Different methods of examining psychotherapy reflect and complete the image of the psychotherapy process. 3. The psychotherapy process’s complexity and the difficulty in describing the effect of therapy with simple measurements or remaining psychiatric symptoms. Positive change in several areas, such as the child experiencing increased independence, gets access to more positive affections, has improved self-esteem and a more optimistic idea of the future, could be described as psychological phenomena and can be difficult to encompass with narrow psychiatric terminology. 4. The intersubjectivity between child and psychotherapist appears essential. The therapist’s attitude and interventions are characterized by creating a steady therapeutic framework for exploring the child’s problems. 5.  The importance of the therapist’s meta-competence, i.e., overarching competencies that psychotherapists need to use to guide any intervention, what interventions to use, and when they are suitable. / <p>At the time of the doctoral defense, the following paper was unpublished and had a status as follows: Paper 2: Submitted.</p>

The problem with which this investigation was concerned was that of the use of parents as therapeutic agents. The purpose of this study was twofold. The first was to determine the effect of filial therapy on parental acceptance, self-esteem, parent-child relationship, and family environment. A second was to analyze the results and make recommendations concerning the effectiveness of filial therapy as a treatment modality for parents and their children. The experimental design of the study was a nonrandomized, pretest-posttest, control group design.The sample (N=47) consisted of the experimental group (parents N=15, children N=9) who received filial therapy and the control group (parents N=12, children N=ll) who did not. The treatment included ten, two hour weekly parent training sessions. During these sessions the parents were taught the principles of client-centered play therapy and were instructed to conduct weekly one-half hour play sessions at home with their own children. Based on the findings of this study, the following conclusions were drawn: 1) Filial therapy does significantly increase the parents' feeling of unconditional love for their children and 2) Filial therapy does significantly increase the parents' perception of expressed conflict in their family. In addition to the statistically significant results, there were some important trends which were mentioned as directional conclusions. These qualitative judgments include: 1) Filial therapy may be an effective treatment for increasing parents' acceptance of their children, especially parents' feelings of unconditional love; 2) Filial therapy may be a somewhat effective treatment for increasing self-esteem, yet more effective in increasing parents' self-esteem than children's self-esteem; 3) Filial therapy may be an effective treatment for increasing the closeness of the parent-child relationship without altering the authority hierarchy; 4) Filial therapy may influence the family environment, especially in the areas of expressiveness, conflict, independence, intellectual-cultural orientation, and control; and 5) Filial therapy may be an effective treatment for increasing parents' understanding of the meaning of their childrens' play.